Alzheimer's disease (AD) affects 4 million people in the US. The prevalence doubles every five years beyond age 65. At present, the cognitive features of preclinical AD are identified through standard neuropsychological assessment that typically involves the administration of a battery of tests, often taking 2-3 hours. We propose to develop a brief (10 minute) computerized test that can be completed by the patient in a physician's examining room. The proposed Computer-based Assessment of Mild Cognitive Impairment (CAMCI), will collect data in a standardized fashion while being simple, non-threatening and user-friendly and will reliably identify older individuals experiencing cognitive difficulties. The behavioral tests will assess working memory, incidental memory and prospective memory, executive function, language and psychomotor speed. Initial pilot results show that the test can be administered in a clinical setting and can discriminate between older individuals with and without mild cognitive impairment and at risk for Alzheimer's. The Phase I of the project will involve running 60 patients and 4 nurses to collect data on the effectiveness of the test administration and sensitivity as an effective initial screen for mild cognitive impairment (MCI) and Alzheimer's. The CAMCI is based on currently accepted mental status assessments and currently accepted criteria for the identification of preclinical dementia. This will provide valuable information as to the outcome of mild cognitive impairment as patients can be tracked over interval visits to their primary care physician. Finally, and most important, identifying older people who are in the very beginning stages of a dementing illness will allow therapeutic intervention in the earliest stages of the disease, which, in turn, will slow or even prevent the progression of the disease. The ultimate goal is to improve the quality of life of people in the early stages of cognitive decline and to reduce health care costs by preventing further decline. There is a critical need and commercially viable market to provide better diagnostic instruments for MCI and AD. [unreadable] [unreadable]